Which of the following antibiotics is primarily eliminated by the kidney?

The correct answer is related to the elimination pathways of the antibiotics listed. Clindamycin is primarily metabolized by the liver and then eliminated through biliary excretion and feces, rather than being eliminated significantly by the kidneys.

Vancomycin is an antibiotic that is predominantly eliminated by the kidneys, specifically through glomerular filtration and tubular secretion. This feature is important for clinicians to understand because dose adjustments for vancomycin may be necessary in patients with impaired renal function to prevent toxicity.

Tobramycin is also primarily eliminated by the kidneys. Being an aminoglycoside, it is excreted via renal filtration, and its clearance is largely dependent on renal function.

Aztreonam, a monobactam antibiotic, similarly undergoes renal elimination. Its pharmacokinetics involve significant renal clearance, requiring careful dosing considerations in patients with compromised renal function.

In summary, both vancomycin and tobramycin, as well as aztreonam, are primarily eliminated by the kidneys, while clindamycin does not follow this elimination pathway.